KRAS/Ras Mutation Colorectal Cancer

KRAS mutations are the most prevalent oncogenic alterations in colorectal cancer (CRC), occurring in approximately 45% of cases and driving tumor initiation and progression. These mutations are particularly common in microsatellite stable, right-sided CRC and are associated with a poorer prognosis. Importantly, KRAS mutations render tumors resistant to anti-EGFR therapies, making mutation testing essential for all patients with metastatic CRC. Although direct targeting of KRAS has historically been challenging, recent advances have led to the development of KRASG12C inhibitors, marking a significant breakthrough. This review outlines progress in direct KRAS inhibition, explores alternative therapeutic strategies for KRAS-mutant CRC, and summarizes key findings from completed and ongoing clinical trials.